November 7, 2008 / 57(44);1197-1200
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5744a1.htm?s_cid=mm5744a1_e
Hazardous Chemical Incidents in Schools --- United States, 2002
Chemicals that can cause adverse health effects are used in many
elementary and secondary schools (e.g., in chemistry laboratories, art
classrooms, automotive repair areas, printing and other vocational
shops, and facility maintenance areas) (1). Every year, unintentional
and intentional releases of these chemicals, or related fires or
explosions, occur in schools, causing injuries, costly cleanups, and
lost school days (1).
The federal Agency for Toxic Substances and Disease Registry (ATSDR)
conducts national public health surveillance of chemical incidents
through its Hazardous Substances Emergency Events Surveillance (HSEES)
system. To identify school-related incidents and elucidate their
causes and consequences to highlight the need for intervention, ATSDR
conducted an analysis of HSEES data for 2002period, 423 chemical incidents in elementary and secondary schools
were reported by 15 participating states. Mercury was the most common
chemical released. The analysis found that 62% of reported chemical
incidents at elementary and secondary schools resulted from human
error (i.e., mistakes in the use or handling of a substance), and 30%
of incidents resulted in at least one acute injury. Proper chemical
use and management (e.g., keeping an inventory and properly storing,
labeling, and disposing of chemicals) is essential to protect school
building occupants. Additional education directed at raising awareness
of the problem and providing resources to reduce the risk is needed to
ensure that schools are safe from unnecessary dangers posed by
hazardous chemicals.
ATSDR established HSEES in 1990 to collect data about acute hazardous
substances releases (2). HSEES funds state health departments through
a competitive program announcement to collect information about
eligible events and enter the data into a standardized, ATSDR-provided
web-based system. Each of these states employs a state HSEES
coordinator. Under HSEES, a substance is considered hazardous if it
might reasonably be expected to cause adverse health effects to
humans. The HSEES protocol defines an eligible event as an
uncontrolled or illegal release, or threatened release, of one or more
hazardous substances in a quantity sufficient to require removal,
cleanup, or neutralization according to federal, state, or local law.
However, the definition of an eligible incident varies among HSEES
states because minimum reporting requirements vary according to state
and local laws. State health department programs actively gather
information for HSEES by negotiating agreements with state and local
agencies that are notified routinely when hazardous substances
emergencies occur. Among these agencies are police and fire
departments, environmental agencies, and various emergency response
offices. The states also use news reports for identifying events. In
each state, the HSEES coordinator reviews the circumstances
surrounding each event, including the factors that contributed to
school-related events.
In 2002, HSEES began collecting information to identify the primary
contributing factors associated with chemical incidents. During
2002related chemical events. Eleven state health departments (Colorado,
Iowa, Minnesota, New Jersey, New York, North Carolina, Oregon, Texas,
Utah, Washington, and Wisconsin) reported school-related events for
all 6 years, and four additional state health departments reported
events for some of those years (Mississippi: 2003, Missouri:
2002
During 2002incident were reported to HSEES in the 15 states. Of these, 423
occurred in elementary and secondary schools. The annual proportion of
all events that were school related for each state was consistent
across the reporting period and ranged from 1% to 3%. School-related
events most often resulted from human error (62%) (e.g., improper
chemical storage and unsafe, improper use of materials or equipment),
equipment failure (17%) (e.g., broken hoses, valves, or pipes), or
intentional acts (17%) (e.g., using homemade chemical bombs [bottle
bombs] [3] or 2-chloroacetophenone [i.e., mace or pepper spray
pranks]) (Table 1). Among the 423 chemical incidents in elementary and
secondary schools, 31% resulted in at least one acute injury and 52%
resulted in an evacuation. Of the 74 incidents caused by intentional
acts, 43% were associated with an injury.
A total of 895 persons were injured in the 423 school-related
incidents. No injuries were fatal, but 11 persons were admitted to a
hospital. Most injured persons received first aid on the scene, sought
care from a private physician, or were treated at a hospital but not
admitted. The health effects most commonly associated with the short-
term release of carbon monoxide were nausea, dizziness, and headache.
The release of acids and mace or pepper spray resulted primarily in
respiratory and eye irritation. Most (86%) HSEES school incidents
involved the release of only one chemical. Although mercury was the
most common hazardous substance released (29%), only 2% of mercury-
related incidents caused an injury (Table 2). Conversely, although 4%
of releases were mace or pepper spray by students, these incidents
were associated with a high rate of injury (86%) and evacuation (90%).
Releases (usually spills) of hydrochloric acid, commonly found in
chemistry classrooms, also resulted in a significant rate of injury
(58%). Carbon monoxide releases, caused primarily from equipment
failure in old air-conditioning and heating systems, also resulted in
a high rate of incidents with injury (48%) and evacuation (81%).
Reported by: WA Wattigney, MStat, MF Orr, MS, GD Williamson, PhD, Div
of Health Studies, Agency for Toxic Substances and Disease Registry; S
Everett Jones, PhD, JD, Division of Adolescent and School Health, CDC.
Editorial Note:
During 2002reported by the 15 states participating in HSEES. The findings
indicate that approximately 30% of chemical exposures resulted in
acute injury. Mercury was the most commonly reported chemical
released, but the rate of injury associated with mercury was low. This
might be explained by the fact that HSEES captures acute health
effects and mercury is only immediately toxic at extremely high doses,
which would not be expected at schools. Before the dangers associated
with mercury were fully understood, mercury was commonly used in
thermometers, sphygmomanometers, and barometers and was used in
science experiments in schools. Eleven states (Indiana, Illinois,
Maryland, Michigan, Minnesota, New York, North Carolina, Ohio, Rhode
Island, South Carolina, and Wisconsin) have enacted legislation that
bans or requires reduced use of mercury in schools (4). HSEES data
indicate, however, that mercury is still present in many schools and
spills continue to cause school lockdowns, dangerous exposures, and
costly cleanups.
Like an earlier analysis of 1993for 2002continue to be the result of mistakes in the handling or use of a
substance. These data suggest school staff members might benefit from
additional training on how to use and handle hazardous chemicals to
reduce injuries occurring at schools.
HSEES data are used to guide intervention strategies to reduce the
occurrence of chemical incidents and subsequent injuries (2). For
example, data from HSEES indicating that mercury is the most commonly
reported chemical released in school chemical incidents have been used
to actively promote the removal of mercury-containing equipment from
schools. New York state has developed information resources to guide
proper cleanup of mercury spills, thereby reducing the risk for
exposure and the on-site costs associated with cleanup.* These
resources, and others, are available to all states. The School
Chemical and Laboratory Safety Guide,=86 from CDC, also is a valuable
resource that provides teachers with information to prevent or
minimize harmful exposures in high school chemistry laboratories.
Reducing unnecessary hazardous substances in schools, along with
proper labeling and education on the proper use of potentially
dangerous substances, is imperative to ensure school safety.
The findings in this report are subject to at least three limitations.
First, reporting of events to HSEES is not mandatory, and reporting
sources vary among the states participating in HSEES. Therefore, some
school events likely are not reported, and reporting of school events
to HSEES might be more complete for some states than for others.
Second, the definition of eligible events varies among states
according to their reporting resources, state and local laws, and
capacity to follow up on events. As such, some states might capture
more events that are less severe (i.e., events that do not result in
serious injury or evacuation) than others. Finally, other factors
might result in underreporting of school chemical incidents.
CDC's School Health Policies and Programs Study 2006 found that most
school districts in the United States had policies on how to use
(81%), label (85%), store (88%), and dispose of (87%) hazardous
materials (7). An even greater percentage of schools nationwide had
plans on how to use (92%), label (90%), store (93%), and dispose of
(93%) hazardous materials, and 78% of schools kept an inventory of
hazardous materials (7). However, to support those policies and plans,
school districts and schools need resources to ensure proper chemical
management. For example, school districts need assistance in building
their capacity to systematically inventory, remove, and manage
potentially dangerous chemicals.
To reduce chemical misuse and improve chemical management in schools,
the Environmental Protection Agency developed the Schools Chemical
Cleanout Campaign and Prevention Program (SC3), a national strategy
that incorporates models, tools, and guidance from pilot programs,
along with building a national network of community partners to assist
schools.=A7 Using this program, government agencies, private companies,
and community leaders can work with schools to 1) increase awareness
about the risks associated with chemicals in schools; 2) facilitate
the removal of outdated, unknown, unneeded, and potentially dangerous
chemicals; 3) prepare teachers and schools to use less dangerous
chemicals and in smaller quantities where appropriate; and 4) provide
inventory tools and information to better manage chemicals that cause
safety and health concerns in schools.
References
1. Audi J, Gellar RJ. Chemical exposure in and out of the classroom.
In: Frumkin H, Geller R, Rubin IL, eds. Safe and healthy school
environments. New York, NY: Oxford University Press; 2006:189--204.
2. Agency for Toxic Substances and Disease Registry. Hazardous
Substances Emergency Events Surveillance system. Atlanta, GA: US
Department of Health and Human Services. Available at
http://www.atsdr.cdc.gov/hs/hsees
.
3. CDC. Homemade chemical bomb events and resulting injuries---
selected states, January 1996--March 2003. MMWR 2003;52:662--4.
4. Berkowitz Z, Haugh GS, Orr MF, Kaye WE. Releases of hazardous
substances in schools: data from Hazardous Substances Emergency Events
Surveillance system, 1993
5. US Environmental Protection Agency. State mercury school programs:
state legislation and regulations. Available at
http://www.epa.gov/epawaste/hazard/tsd/mercury/laws.htm
.
6. Associated Press. Mercury spill causes scare but no danger at
Fallon school. Nevada Appeal. February 26, 2008. Available at
http://www.nevadaappeal.com/article/20080227/region/298489457
.
7. Everett Jones S, Axelrad R, Wattigney WA. Healthy and safe school
environment, part II, physical school environment: results from the
School Health Policies and Programs Study 2006. J Sch Health
2007;77:544--56.
* Available at
http://www.health.state.ny.us/environmental/chemicals/hsees/mercury/index.
htm
.
- Available at http://www.cdc.gov/niosh/docs/2007-107.
=A7 Additional information available at http://www.epa.gov/sc3.
TABLE 1. Number and percentage of chemical incidents* in elementary
and secondary schools, associated injury, and ordered evacuation, by
contributing factor
Hazardous Substances Emergency Events Surveillance system, 15 states,
2002-2007 http://www.cdc.gov/mmwr/preview/mmwrhtml/figures/m744a1t1.gif
TABLE 2. Number and percentage of specific chemicals released in
elementary and secondary schools, and associated injury and ordered
evacuation, by type of chemical
Hazardous Substances Emergency Events Surveillance system, 15 states,
2002-2007
http://www.cdc.gov/mmwr/preview/mmwrhtml/figures/m744a1t2.gif

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